an interesting First Responder Catch-22

[topaz]

More first responder training tonight.  We finally got our books!  That will be awesome -- I have been taking copious notes, and when questions come up, Mike has provided good and clear answers, but I'm certain I've been missing some stuff.  Tonight's class was all about vital signs, recognizing different classes of shock, and how to treat different classes of wounds.

But here's the snag: we can't administer an Epi-Pen.

First responders are trained to provide a very specific level of emergency aid.  We can dress wounds, splint fractures, administer CPR, that sort of thing.  We cannot go beyond our scope of training.  That makes sense -- they don't want a bunch of kids who have gotten 30 hours of classroom instruction to go swaggering out in the world thinking they can perform emergency tracheotomies.

Among the things first responders are not allowed to do is administer medication.  Which includes the Epi-Pen.

Now, our neighbors include one young boy with a very severe peanut allergy.  We all got instruction from them on how to use the Epi-Pen, in case he were to go into shock when his parents aren't around.  My spouse has an allergy to bee stings severe enough to keep an Epi-Pen in her purse.

As a regular joe, I would be covered under the Good Samaritan law if I were to administer the Epi-Pen to someone in good faith.  But for trained first responders, the Good Samaritan law only covers you as long as you stay within your scope of training.

My reading of this is that, until I get my first responder certification, I can legally use the Epi-Pen on someone who's going into shock.  After that, doing so could expose me to liability if anything were to go wrong.

It all reminds me of Michael Pollan's discovery of the bizarre legal rabbit-hole around the poppy: that if you wish to grow opium poppies, you can do so provided you do not know what they are -- that once you realize that fact, you can be held liable for drug trafficking.  It's kinda loopy.  But there we are.

Comments

[fengshui.livejournal.com]

I think the question here lies in the "whose usual and regular duties do not include the provision of emergency medical care" clause. A lawyer could make the argument that someone who is a certified first responder is someone whose usual and regular duties *in an emergency* include the provision of medical care. Now, whether a single kid needing an Epi-Pen counts as a situation wherein Tim was acting as a First Responder is hard to say.

[docstrange.livejournal.com]

That's probably not the argument that would stick as it is patently not what the statute intends, else why would the statute even mention usual and regular duties? First aid is generally rendered in an emergency. However, that argument and others that perhaps could stick would be made and rebutted at very high cost to the defendant in the civil suit.

Lemme putitthisway: "You don't want to be a test case." It costs a lot.

All that said, to qwrrty: Don't take medical advice from a law firm; don't take legal advice from a medical organization. You're talking about my specialty area - risk mitigation and negligence law - and I won't hazard a guess outside my state of licensure as to such an interpretation of MA law, and I sure would not trust a chain of command entrusted with CYA for themselves on the legal front, rather than giving firm legal advice to you. Trust their medical training, but as to the MGL, ask a MA lawyer who researches and handles cases under MGL 112 §12V.

[creidylad.livejournal.com]

The reason you need a lawyer to clarify this stuff is that they will know how the MA courts have interpreted this legal wording in the past.

[qwrrty.livejournal.com]

I take your point. However, as recently as 2003, the director of the DPH's Drug Control Program found it necessary to recommend through a memo to the Public Health Commissioner (http://www.mass.gov/Eeohhs2/docs/dph/quality/drugcontrol/amend_antidotes.pdf) that the law be amended explicitly to permit first responders to administer epinephrine auto-injectors. So my impression is that this is a widely recognized side effect of Massachusetts public policy and not just the perception among EMTs who may have been fed a bad line.

[harimad.livejournal.com]

The fact that the legislature *hasn't* made the change when it was clearly given the opportunity to, is strong indication that it doesn't want to. So per Youngstown Sheet and Steel[1] the MA courts are likely to say that epi-pens really are not an exception.

This is free legal advice from someone who hasn't practiced in over a decade. It's probably worth what you paid for it. It *is* worth asking a competent MA lawyer about.

Also worth asking him about is a spousal exception, and whether you can get specific written permission from your neighbor (and wife, if there isn't a spousal exception) to administer the epi-pen.


[1] That I was just talking about this am, weirdly enough.

[keyne.livejournal.com]

Also worth asking him about is a spousal exception, and whether you can get specific written permission from your neighbor (and wife, if there isn't a spousal exception) to administer the epi-pen.

I'm actually not planning to sue. So far :-)

[qwrrty.livejournal.com]

I have to tread carefully!

[cruiser.livejournal.com]

Yeah, but if you croak, maybe Morgan or Quinn will - has either expressed an interest in being a lawyer when he grows up?

[docstrange.livejournal.com]

Is a "first responder" meaning an employed EMT? Being certified doesn't make it your job - not your usual and regular duty, hmm? I don't think the orgs are doing much more than CYA unless there is a case on point. This is why a MA atty is necessary.